The Right Prescription

Obamacare Is Killing Rural Hospitals and Their Patients

Since 2010, rural hospitals have been put out of business at a rate of one a month.

Among the talking points deployed by Obamacare apologists in their effort to save “reform” is the claim that repeal will cause thousands to die due to the loss of health insurance. This nonsense is based on the fiction that repeal will cause tens of millions to instantly lose health coverage and on debunked studies showing that the lack of insurance causes premature death. Strangely, the compassionate champions of the potentially uninsured seem unmoved by the very real carnage wrought by Obamacare’s destruction of rural hospitals. Since 2010, 80 such facilities have closed, a trend that is killing patients right now.

Most of these shuttered hospitals provided the only realistic source of accessible emergency care for patients living in the rural communities they served. If you live in the area once served by Colusa Regional Medical Center in rural California, for example, you would be ill-advised to have a heart attack. To get you to a hospital your ambulance will have to drive past that now-closed facility in order to get you to the nearest ER. When asked why the hospital was forced to close, the CEO included the following among the principal reasons: “The Affordable Care Act and its reimbursement model for Medicaid and Medicare.”

This model is the result of a bait-and-switch perpetrated on the hospital industry by the White House and congressional Democrats. In 2009, the industry agreed to support Obamacare by accepting $155 billion in cuts to their Medicaid and Medicare payments in exchange for a promise that “reform” would flood hospitals with millions of newly insured patients whose coverage would offset the concession. Predictably, Obamacare fell short of its goals and 97 percent of its enrollees were dumped into Medicaid, which pays hospitals well below the cost (cost, not charges) of treating patients covered by that program.

All of this means that rural hospitals are rapidly becoming extinct and that, if you are one of the 60 million Americans who make their homes in rural areas, this is a very dangerous trend for your health. In other words, when your ambulance has to be driven past a facility that has been forced out of business by Obamacare, your chances of dying on the way to — or after you finally reach — the next hospital down the road have been significantly increased. Unlike the “research” predicting zillions of deaths if the law is repealed, this is the conclusion of a legitimate study reported by the American College of Emergency Physicians:

Patients admitted to the hospital in the geographic vicinity of other emergency department closures had 5 percent higher odds of inpatient mortality than patients who were admitted in areas where no emergency department had closed.… Odds of mortality increased by 10 percent for non-elderly adults, by 15 percent for patients with AMI, by 10 percent for patients with stroke and by 8 percent for patients with sepsis.

Nonprofit Quarterlyreports that 673 rural hospitals are vulnerable to closure. In other words, their financial situations are comparable to those which have closed their doors since 2010. And now, in addition to being underpaid by Medicaid, they are of course suffering from yet another problem directly attributable to Obamacare: “Increasing insurance deductibles and co-pays are leaving insured patients and their families with larger medical bills.… Some families are unable to make timely payment, adding to hospitals’ cash flow problems.” And it gets worse. NPQ also reports another destructive proposal by the Obama administration:

A looming threat for rural hospitals… is a proposal by the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) to reduce rural hospitals’ reimbursement for so-called “swing bed” reimbursement by up to 462 percent. Swing beds are beds recognized by Medicare as being available for use either as an acute hospital bed or as a rehabilitation bed (usually post-surgery but before a patient is cleared to return home).

If the geniuses who run the Obama administration’s health care bureaucracies were deliberately attempting to destroy the rural hospital system, they couldn’t do much more damage. Rural facilities constitute about 37 percent of America’s community hospitals. If they continue to go under at the rate they have been failing since Obamacare reared its ugly head, patient access will plummet precipitously, hundreds of thousands of hospital and hospital related community jobs will disappear, and hundreds of billions will vanish from the nation’s Gross Domestic Product. And, of course, a lot of people living in America’s heartland will die.

Obamacare apologists predict all manner of dire consequences if the widely reviled law is repealed, including thousands of unnecessary patient deaths. But they have ignored the rural health crisis that was caused by the “reform” law and is killing people right now. This is just one more reason to ignore the law’s dead-enders and repeal this travesty now.